HMO Supplementation Favorably Shifts Microbiome, Metabolism in UC Patients: Study

A clinical study published in the Journal of Crohn’s and Colitis found that four weeks of supplementation with a human milk oligosaccharide (HMO) called 2′-Fucosyllactose (2′-FL) improved patient-reported outcomes in a population of people with mild-to-moderate ulcerative colitis (UC).

HMOs are emerging beyond infant nutrition as clinical researchers explore their potential to support gut health, immune function, healthy inflammatory responses, and other outcomes in adults.

“UC is an inflammatory bowel disease defined by chronic inflammation affecting the mucosal layer of the colon … the gut microbiota composition and function in UC is different to that of healthy people, with a reduction in abundance of more beneficial bacteria such as Bifidobacterium and Faecalibacterium prausnitzii, with a corresponding reduction in beneficial metabolites such as short-chain fatty acids in the colon during active inflammation.”

Human milk oligosaccharides have various health benefits primarily within the microbiome, as well as through direct pathogen inhibition and modulation of immunity and inflammation, the authors noted.

In the randomized, double-blind, placebo-controlled study, 38 participants with UC were randomized to receive either a daily 2′-FL supplement or a matching placebo for four weeks, followed by a washout and crossover. Patient-reported outcomes and samples of feces, urine, and serum were collected before and after each intervention, and after a final washout period.

While no clear treatment effect was observed on conventional clinical indices (Simple Clinical Colitis Activity Index scores or remission rates), patients reported improvements in their disease control, authors noted, though self-reported improvements should be interpreted with caution.

Over the treatment window, 2′-FL significantly shifted the microbiota, markedly increasing the abundance of Bifidobacterium. Fecal metabolite profiles also showed changes consistent with altered microbial carbohydrate metabolism. Age appeared to correlate with responsiveness to treatment, with older adults experiencing greater effects in microbiome and metabolomic changes.

“Although 2′-FL alone at the dosage used in this study may not have resulted in clinical response for all participants, the potential role of many other HMOs in IBD, alone or in combination, has yet to be explored. In this respect, the story of prebiotics in IBD has only really just begun, and will be a promising area of research going forward for clinicians and patients alike,” the authors concluded. “Clinical effects of a prebiotic are, of course, not expected to match those of immunosuppressive therapy, as we are considering foods as opposed to pharmaceuticals. However, they may represent a low-risk, well-tolerated adjunct to current therapy options to improve disease control and quality of life for people living with UC.”